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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2008

01-05-2008 | Breast Oncology

Technical Considerations in Nipple-Sparing Mastectomy: 82 Consecutive Cases without Necrosis

Authors: Alan J. Stolier, MD, Scott K. Sullivan, MD, Frank J. Dellacroce, MD

Published in: Annals of Surgical Oncology | Issue 5/2008

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Abstract

Background

Even without comparative trials, nipple-sparing mastectomy (NSM) is gaining traction in the treatment of established breast cancer and in the prophylactic setting. As yet, there are no established techniques that are universally applied to NSM. Herein we describe our surgical approach.

Methods

All mastectomies performed by a single surgeon (AJS). Reconstructions performed included synthetic implants, deep inferior epigastric (DIEP) and gluteal artery perforator flaps (GAP). A lateral incision (12.1%) and a 6:00 radial incision (87.9%) were used in all patients. The areola was elevated just beneath the deep dermis and ductal tissue within the nipple papilla was “cored”.

Results

Fifty-eight patients underwent 82 NSMs for both cancer and prophylaxis. No patient developed necrosis of the nipple-areola complex (NAC). Minor skin-edge necrosis not involving the NAC occurred in 2 patients. Four patients developed a hematoma, 2 requiring re-operation. One patient required re-operation to correct a vein problem. There were no flap losses.

Conclusions

NSM can be performed with a minimal incidence of skin-flap related complications. In our hands, radial incisions perform well in this regard. Indications for NSM and the optimal technique are yet to be determined.
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Metadata
Title
Technical Considerations in Nipple-Sparing Mastectomy: 82 Consecutive Cases without Necrosis
Authors
Alan J. Stolier, MD
Scott K. Sullivan, MD
Frank J. Dellacroce, MD
Publication date
01-05-2008
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 5/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-007-9753-5

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